Provider Demographics
NPI:1225701360
Name:PIONEER COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:PIONEER COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-33932
Authorized Official - Phone:208-263-4145
Mailing Address - Street 1:819 HWY 2
Mailing Address - Street 2:SUITE 211
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-1678
Mailing Address - Country:US
Mailing Address - Phone:208-263-4145
Mailing Address - Fax:208-263-4145
Practice Address - Street 1:819 HWY 2
Practice Address - Street 2:SUITE 211
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1678
Practice Address - Country:US
Practice Address - Phone:208-263-4145
Practice Address - Fax:208-263-4145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1407218209Medicaid